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Wyoming rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.68 / $47.68 / $80.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.00 / $132.00 / $218.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.26 / $87.37 / $140.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.45 / $159.35 / $245.52